Genetic, Epigenetic Advances Will Greatly Influence NAFLD Treatment

Major changes are in the works for the treatment of nonalcoholic fatty liver disease (NAFLD). Recent advances in the understanding of genetic and epigenetic alternations that influence the development and progression of NAFLD are poised to transform the clinical world.

“There has been dramatic development and breakthroughs in understanding how genetics and epigenetics determine both the pathogenesis and natural history of NAFLD,” said Leon Adams, MBBS, PhD, Associate Professor of Health and Medical Sciences at the University of Western Australia Medical School in Perth, Australia. “The Special Interest Group program on NAFLD is going to span the spectrum of breakthroughs from basic research to clinical translation into personalized medicine approaches.”

Dr. Adams will co-chair “Advances in Genetics and Epigenetics in NAFLD: From Pathogenesis to Personalized Medicine” with Wajahat Z. Mehal, PhD, MD, Professor of Medicine and Director of the Yale Fatty Liver Disease Program, Weight Loss Program and Tissue Regeneration and Fibrosis Program. The session runs on Friday from 2:00 pm – 4:00 pm in Room 24/25, Moscone North/South.

Medical research seldom progresses at an even pace and NAFLD is no exception. Work in pathogenesis is still largely in the discovery phase, Dr. Adams said. While much of the work remains in the discovery phase, new therapeutic targets are already emerging.

Elizabeth K. Speliotes, MD, PhD, MPH, Associate Professor of Gastroenterology and Internal Medicine at the University of Michigan, will discuss the latest findings from population level genetic studies which have uncovered novel pathways of disease pathogenesis and demonstrated the importance of genetics in determining risk of progressive fibrosis and hepatocellular carcinoma.

“There are no approved treatments for NAFLD, and so there is a tremendous effort being undertaken to translate advances in genetics and epigenetics into the clinic,” Dr. Adams noted. “It is already clear that advances made in the last five years are going to influence clinical practice in very profound ways.”

Christopher K. Glass, MD, PhD, Professor of Medicine and of Cellular and Molecular Medicine at the University of California San Diego, will discuss the current evidence for specific mechanisms by which genetics regulate inflammation and liver injury in nonalcoholic steatohepatitis. Derek A. Mann, FMedSci, Professor of Hepatology at Newcastle University and Director of the Newcastle Fibrosis Research Group in Newcastle, UK, will outline what is known about epigenetic regulation of fibrosis and highlight its potential as an effective treatment target.

Current work in both genetics and epigenetics is already producing new understanding into the importance of genetic polymorphisms in both the pathogenesis of NAFLD and response to treatment as well providing as novel clinical targets, Dr. Adams said.

Luca Valenti, MD, PhD, Associate Professor of Internal Medicine and Metabolic Diseases at the Universita degli Studi Di Milano and Coordinator of the Research Laboratory of Metabolic Liver diseases at Fondazione Ca’ Granda OMP in Milan, Italy, will discuss the clinical impact of new findings in genetic variants and epigenetic modifications in NAFLD in diagnosis, prognosis and therapeutics. “These novel breakthroughs are going to change the paradigm of treatment for NAFLD patients in the future, either through better understanding of pathogenesis and thereby understanding what kind of treatments will be most effective, and in diagnostics and prognosis,” Dr. Adams said. “We have increasing data on the role of genetic polymorphisms in diagnostic and prognostic algorithms as well as increasing data on how they may influence responses to treatment.”

“The paradigm of personalized medicine is coming in NAFLD,” he continued. “This session is going to prepare all of us to better understand and embrace that paradigm of personalized medicine for our patients with NAFLD.”